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Job Posting Title

Quality Specialist II

Job Description Summary

Serves as a member of the quality team at the national, regional or unit level. Coordinates projects resulting in continuous quality improvement and process improvement. Supports the maintenance of a strong quality program, measured processes including URAC, NCQA, and/or HEDIS (where applicable) and reported outcomes.

Job Description

• 2+ years of quality improvement and auditing or related in healthcare field.

• 2+ years of HEDIS related experience (where applicable).

• Coordinates assigned quality and process improvement activities which may include accreditation support, process improvement projects, quality studies, CQI (continuous quality improvement) process training for staff, prevention program coordination, care coordination initiatives, satisfaction survey coordination and follow-up, provider and member advisory groups (where applicable), tracking of adverse incidents, monitoring of performance guarantees, CAPs and customer related quality initiatives.

• Knowledgeable in HEDIS (where applicable) and Accreditation (NCQA and/or URAC) requirements.

• Conducts quality control reviews and external/internal audits.

• Summarizes findings and prepares reports on findings.

• Assists in the preparation of customer audits.

• Conducts analyses of data findings for quality and process improvement and assists in report preparation for internal and external customers.

• Leads and/or supports assigned quality committees and/or work groups through comprehensive project management, ensuring that documentation is accurate and timely, agenda items presented, and follow-up actions taken.

• Supports the quality program with the goal to meet customer requirements and performance guarantees. Duties include monitoring and execution to meet timely deliverables.

• Works independently and high degree of organization required.

• Knowledge of healthcare quality improvement processes, accreditation standards, and HEDIS/performance measurement.

• Attention to detail and ability to work efficiently to meet deadlines and timelines.

• Expertise in data management, data analysis, reporting word processing, and project management skills.

• Strong working knowledge of Microsoft Excel, VISIO, and/or MS Project.

• Excellent verbal and written skills and the ability to enter data accurately into spread sheets and prepare professional looking documents and reports.

Responsibilities

• 2+ years of quality improvement and auditing or related in healthcare field.

• Knowledge of healthcare quality improvement processes and performance measurement.

• Attention to detail and ability to work efficiently to meet deadlines and timelines.

• High degree of organization required.

• Expertise in data management, data analysis, reporting word processing, and project management skills.

• Strong working knowledge of Microsoft Excel, VISIO and MS Project.

Work Experience

Work Experience - Required:

Quality

Work Experience - Preferred:

Education

Education - Required:

Education - Preferred:

Bachelors - Healthcare

Certifications

Certifications - Required:

Certifications - Preferred:

LSSGB - Lean Six Sigma Green Belt Certification - Enterprise - Enterprise, LSSWB - Lean Six Sigma White Belt Certification - Enterprise - Enterprise

Potential pay for this position ranges from $54,190.00 - $86,690.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (https://www.primetherapeutics.com/careers/benefits/) and click on the "Benefits at a glance" button for more detail.

Prime Therapeutics LLC is an Equal Opportunity Employer. We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, genetic information, marital status, family status, national origin, age, disability, veteran status, or any other legally protected class under federal, state, or local law.

Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.

If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives.

Prime Therapeutics LLC is an Equal Opportunity Employer. We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status. ​ If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email Careers@primetherapeutics.com.